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This study aims to compare the analgesic efficacy of quadratus lumborum block (QLB) and retrolaminar block (RLB) in patients undergoing lumbar disc herniation surgery. Both regional anesthesia techniques are increasingly used for postoperative pain management, but there is limited evidence directly comparing their effectiveness. The primary outcome is the postoperative pain score, while secondary outcomes include opioid consumption and patient satisfaction.
Effective postoperative pain management is essential in patients undergoing lumbar disc herniation surgery. Regional anesthesia techniques, such as quadratus lumborum block (QLB) and retrolaminar block (RLB), have been increasingly used as alternatives or adjuncts to systemic analgesics. QLB provides analgesia by targeting the thoracolumbar fascia and spreading to the paravertebral space, whereas RLB is considered a simpler and potentially safer approach with similar analgesic potential.
This randomized controlled clinical trial is designed to compare the efficacy and safety of QLB and RLB for postoperative pain control. Adult patients scheduled for elective lumbar disc herniation surgery under general anesthesia will be randomized into two groups. One group will receive ultrasound-guided QLB, and the other group will receive ultrasound-guided RLB before surgical incision.
The primary outcome is postoperative pain intensity measured using a numerical rating scale (NRS) at multiple time intervals within the first 24 hours after surgery. Secondary outcomes include total opioid consumption, time to first analgesic request, incidence of block-related complications, and overall patient satisfaction. The results of this study are expected to provide evidence for the optimal regional technique for postoperative analgesia in lumbar spine surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quadratus Lumborum Block | Experimental | Patients randomized to this group will receive an ultrasound-guided quadratus lumborum block (QLB) with local anesthetic injection before surgical incision for postoperative pain management. |
|
| Retrolaminar Block | Experimental | Patients randomized to this group will receive an ultrasound-guided retrolaminar block (RLB) with local anesthetic injection before surgical incision for postoperative pain management. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quadratus Lumborum Block | Procedure | Ultrasound-guided quadratus lumborum block performed preoperatively using local anesthetic injection at the thoracolumbar fascia for postoperative analgesia in lumbar disc herniation surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain intensity (NRS score) | Pain intensity will be assessed using the Numerical Rating Scale (0-10) at rest and during movement. | Within the first 24 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Total opioid consumption | Total amount of opioid analgesics (morphine equivalent) administered in the first 24 hours postoperatively. | 24 hours after surgery |
| Time to first analgesic request | Time interval between the end of surgery and the first request for additional analgesia. |
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Inclusion Criteria:
Patients aged 18-65 years American Society of Anesthesiologists (ASA) physical status I-II-III Scheduled for elective lumbar disc herniation surgery under general anesthesia Willing to participate and provide written informed consent Patients scheduled for elective lumbar disc herniation surgery
Exclusion Criteria:
Patients requiring emergency surgery ASA physical status classification IV-V Known coagulopathy Ongoing anticoagulant therapy History of allergy to local anesthetics Localized infection at the block injection site Presence of spinal, paraspinal, or regional deformities at the block area Inability to understand or use the verbal pain rating scale Chronic use of analgesic medications
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| Name | Affiliation | Role |
|---|---|---|
| dilek icli, prof. dr. | Kocaeli University, Department of Anesthesiology and Reanimation | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kocaeli University Hospital | Kocaeli | 41000 | Turkey (Türkiye) |
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Two-arm randomized controlled trial comparing quadratus lumborum block and retrolaminar block in patients undergoing lumbar disc herniation surgery.
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| Retrolaminar Block | Procedure | Ultrasound-guided retrolaminar block performed preoperatively using local anesthetic injection into the retrolaminar space for postoperative analgesia in lumbar disc herniation surgery |
|
| 24 hours after surgery |
| ID | Term |
|---|---|
| D007405 | Intervertebral Disc Displacement |
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006547 | Hernia |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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